Provider Demographics
NPI:1497924583
Name:CARDIAC IMAGING INC
Entity Type:Organization
Organization Name:CARDIAC IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ED
Authorized Official - Middle Name:D
Authorized Official - Last Name:KLINICKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-425-1401
Mailing Address - Street 1:27622 LODESTONE TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-4043
Mailing Address - Country:US
Mailing Address - Phone:949-425-1401
Mailing Address - Fax:
Practice Address - Street 1:27622 LODESTONE TRAIL DR
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-4043
Practice Address - Country:US
Practice Address - Phone:949-425-1401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Single Specialty